My clientele are homeless or marginally housed. They are low-income and many are unable to
work, for a variety of reasons. Many
struggle with addictions. Many struggle
with disabling conditions of mental health.
Many struggle with both addiction and mental health. Most have horrific stories that involve
sexual abuse, physical abuse, mental abuse, neglect. Many grew up in foster care. Many of their families struggle with similar
issues. There are two and three
generations of families that frequent our doors. There are many clients who have diagnosed or
undiagnosed physical or mental conditions, such as FASD, Autism, generalized intellectual
delay or physical ailments. We have a handful of clients who are wheelchair
bound, and more who require the aid of a cane to get around. Our clients are
from multiple nationalities, including Aboriginal. They are seen as less than human, “scum”,
worthless members of society, wasting resources, undeserving of support and
services, to describe just a few of the phrases I have heard them described as.
Many of my clients do not have a family doctor they can see
about any ailments they have. Many have
recently been “fired” from their family doctor.
The stories coming from our
guests is familiar: their long-term doctor retired and the new doctor decided
they didn’t need their pain killers (it’s an addiction not really
required). These patients, in pain and
suffering withdrawal from the powerful narcotics they have been using for many
years, escalate and tell the doctor that they need their prescription. They are
“fired” for escalating and most likely raising their voice in frustration. They
are “fired” for being a junkie. And
within a month, these people take more drastic measures; normally looking like
attempted suicide because they cannot live this life anymore. We call 9-1-1 to help them. In my experience, the first (and only)
responders are the RCMP, who cuff the individual and maybe take them to the
hospital but more likely take them to cells.
Without a family doctor, and unable to go into health
establishments for “inappropriate behaviour”, our people are left only with the
Emergency Room at the local hospital.
The experiences at the hospital have a similar ring to them as
well. “I waited for three hours for them
to tell me I am a degenerate and unworthy of their attention. I waited three hours for them to deny me
services. When I questioned them, stating
I am in a need of medical attention, they tell me they will call the RCMP to
have me removed”. I hear things like “they
told me my condition did not require medical attention, but I never saw the
doctor”. This happens to males and
females, Aboriginal and non-Aboriginals.
It is more noteworthy when we have a guest who is actually seen at the
hospital and not just sent away without receiving any care.
There is a distinct lack of services available to the people
I serve. The unit for psychiatric assessment
and stabilization, which includes management of chemical withdrawal only has
eight beds and the beds are normally full.
We have been told in the last couple of months that chemical withdrawal
is no longer a treatment they can provide.
That means that there is nowhere in town that can offer detox services. We have a centre called “Mental Health and
Addiction Services”. Our guests that
have both mental health and addiction issues are turned away at both ends. Mental health cannot treat them if they are
actively using. Addiction says that they
psychosis they experience is not an addiction issue but a mental health
issue. (I do not see why the two teams
cannot work together and help find a solution to the problem!). Our guests also have their files closed at
Mental Health and Addiction because they miss appointments. I understand that the case loads are heavy,
but having an understanding of mental health issues or addiction issues will
tell you that appointments are hard for people to keep. These clinicians make no effort to come to
the client. They then have to go through
the entire intake process and wait for a clinician to be assigned to them, thus
ruining any relationship they may have had with their previous worker. It is a new thing every time, including
telling their story over again to someone they do not know or trust.
We had a woman who had a heroin addiction, and was using
heavily. She knew she was in
trouble. She tried to get into the psychiatric
treatment ward, whose mandate states the unit is “to provide psychiatric
assessment and stabilization, including management of chemical withdrawal” but
was told there were no beds. She called
the next town and put herself on the waiting list for the detoxification centre
there. She wasn’t sure how she would get
there but knew she needed to help herself.
She overdosed several times, requiring the use of a defibrillator. She showed up at the homeless shelter and
asked us to clean the wound caused by one of the defibrillators. The wound was infected (I did not see it but
a nurse who works with us described it as the grossest thing she has ever
seen). We told this woman she needed to
go to the hospital for treatment. She
said she couldn’t go there again, that she didn’t receive treatment in the
past. We sent a staff member with her
and she had the wound cleaned and was given antibiotics. The doctor at the hospital gave a referral
for medical supplies so that she could clean and dress her chest wound herself
(or, I guess, have the staff at the homeless shelter do it). As she couldn’t afford to buy the supplies,
she had to put in an application to the Ministry of Social Development for
emergency medical supplies funding. The
hoops that had to be jumped through to keep this wound clean! It was a good thing that we were there to
help her because there were a lot of steps to getting funding to provide the
supplies needed. It wasn’t even a week
after we learned of her infection that she passed away.
We had a man who had been living in his own place for about
two months. He came back to the shelter
incredibly sick. He was delusional and hallucinating. He was weak and barely able to walk. He was coughing up blood. He said he had been to the hospital and they
had run some tests. He said he was
supposed to come back in a week. Our staff
took action after a couple of days of him being sick and went to a doctor’s
appointment with him. The doctor told us
he had pneumonia and gave us a prescription.
He continued to get worse. Our
janitorial staff reported there were pools of dried blood under his bed. We took him to the hospital for more
tests. His EKG was way out of whack, his
heart was not working properly. It was
our nurse who took him to the hospital.
She thought he would be admitted that day. He wasn’t.
He was sent back to the homeless shelter. That same night we had to call an ambulance
for him. He died two days later.
We have a young woman who wants to get help with her
addiction. I watched her struggle to say
clean for a week while trying to get into treatment. A staff member and her attended the hospital
with the hopes of getting into the local detox and were turned away. This young woman then called the next town
and put herself on the waiting list for detox there. She called them daily looking for a bed. She wanted to get clean and knows she cannot
do it on her own (and that we are not qualified or capable to help her in the
current setting). She waited all
week. Then the chance was gone for a
while. She has tried to check herself
into the psychiatric ward at least another time since. She came back to the shelter in tears. She was called names and put down by the
nurses at the hospital. She was told
that she had refused treatment last time she was in (she had waited several
hours and had left because she had not seen a doctor yet) and that they weren’t
going to waste their time with her again.
Defeated, she told me that she would never go to the hospital again
because it wasn’t worth her dignity.
We have a young man who was admitted into the psychiatric
facility for a week. When he was
released from the facility, he came and talked to us about treatment options
for himself. He got himself accepted
into a treatment facility in a different part of the province for young
men. He did everything on his own, with
our encouragement and guidance. He
applied for extra money on top of his disability cheque to buy his bus ticket
and the supplies he needs to attend this treatment program. The Ministry of Social Development was happy
to pay his bus ticket and his food/clothing allowance but balked at the intake
fee required by the treatment centre. It
is a private treatment centre so they refused to pay the fee. Frustrated, he told me he should just hang
himself. I encouraged him to hang on, to
let us make some calls. Our staff called
the treatment centre, advocated for him, praised him for taking all the steps
on his own, and the treatment centre agreed to take him without the intake
fee. This young man is over the moon
happy that he is off to turn his life around.
This is my only success story today.
We have a young man, who struggles with drug induced
psychosis (so no help from Mental Health and Addictions because he is the
classic example of how the teams cannot work together to help him – is it addiction
or is it mental health help he needs?).
When this young man is escalating, the only choice staff have if they
are unable to calm him, is to call the RCMP on him and have him removed from
our premises. We try not to call the
RCMP on him, as it is a breach of his trust in us as people who are on his side
and want to help him, but sometimes it is for the safety of himself and our
other guests that we have to make the call.
Last week this young man was called into the RCMP by a community
member. The RCMP were able to get him
admitted into the psychiatric ward for 24 hours under the Mental Health
Act. When he returned to the shelter he
was incredibly upset that staff would betray him like that. We assured him that we did not make the call
but he was unable to believe us.
Yesterday he assaulted a staff member while in a state of psychosis. RCMP came and picked him up, and took him
back the psychiatric facility. He was
turned away at the door. RCMP told us
that they could hold him for a couple hours but that they would have to release
him. Because he has put our staff safety
at risk, he is being denied access to the only home he knows, the shelter. We cannot allow him in as he is posing a
safety risk to staff and other guests. Our
Executive Director is thinking we might have to charge him with assault so that
he does jail time, as that is the only safe place for him right now.
This system is broken.
A mentally ill man, who is suffering right now, has been kicked out of
the only place in town he is comfortable at all. He has nowhere else to go. We are the only shelter. He does not have healthy family to live with.
He is unwell and is unable to maintain his own house. The psychiatric ward will not admit him. Mental Health and Addiction say he is not
their problem. Our only option is to
have him thrown in jail! That is the
last place we want him to be. It breaks
all of our hearts to have that decision made for us.
It is not the first, and it will not be the last time our
guests have to do jail time because of their addiction. Are there treatment options while they are in
jail? If he does his time can he not get
the help he needs while there? It doesn’t
seem to be that way. Our guests return
clean. Within a couple days they are
back into their addiction. I realize our
facility does not help these guests to stay clean as there are so many addicted
people around that it can be easy to fall back into the lifestyle.
We need somewhere where people with addictions can go when
they are ready to make a change. It
needs to be immediate access. At least
once a month a client tells us that they are tired of their lifestyle and want
to make a change. They tell us that they are heading to the hospital to check
themselves into the psychiatric unit.
About three hours later, they return, frustrated, defeated, and often
having used their substance of choice quite heavily. When they get turned away they feel like they
may as well enjoy their substance because they can’t get off it on their own
anyways. We had a man who wanted to go
to detox. By the time we were able to
get him a bed in detox, and even drove him to the centre, he didn’t want to
go. He was back in town the next
day. I asked him what happened. He told me “I wanted to go on Tuesday. By Friday, I didn’t want to go, so I came
back”. When someone wants to make a
change in their lives there needs to be immediate access. People need to be treated with dignity and
respect. They don’t need to be told they
are wasting resources. They don’t need
to be called names. My clients are as
entitled to proper medical care as you and I.
I know that the one day I visited the same Emergency Room as my guests
do, I waited three hours, but I saw a doctor, he was patient and he did his
job. I expect the same treatment for my
clients. My issue was probably less
pressing than the issues my clients show up with, because I know for most of
them, previous treatment tells them they will be treated poorly and they only
go if they absolutely have to.
It is not okay. The
system is not okay. Our guests are
discriminated against from every angle.
They are on social assistance (and half the world thinks they should be
drug tested to receive any money to live on).
Social assistance does not pay enough to live on. They are addicts and have mental health
issues, which is something that scares the general population. (I will admit
that before I knew anything about mental health or addiction, it scared me a
little too). Society looks on our guests
with disdain. In conversations we hear a
lot of “them vs us” – those people do blah, blah, blah. Our guests are ignored when they go places,
or treated rudely and threatened with RCMP.
In the six months I have worked at the shelter, our people have been
told they cannot hang out here but over there.
This changes the next month and they get kicked further away. Currently, they are allowed to gather on a
sandbank on the river. I am waiting for
an accident where one of our guests falls into the river. We are looking for a new facility as ours is
beyond repair. We have a location in
mind, but our neighbours, Mental Health and Addiction do not think we are good
neighbours. Wouldn’t it be interesting
if Mental Health and Addiction could see what we see in our guests, and be
close enough to make meeting the client easier for the client? I did not expect resistance from agencies I
see as on our side, our partners. Our
guests have stories that will break your heart if you are willing to
listen. Our guests deserve the same
treatment you and I expect. I am so
frustrated for them. The system is
broken and our guests suffer the most.
